Unit 4 Goniometry

Question 1

Define Goniometry.

Answer 1

Measurement of Angles.

Question 2

How many planes does goniometry measure at a time?
Why?
Does this have a name?

Answer 2

One plane at a time.
Accuracy is lost if multiple planes are used.
Single plane measurement.

Question 3

What are the 8 reasons to measure a joint?

Answer 3

In order to determine…

1. limitations/impairments.
2. movement diagnosis.
3. functional treatment goals.
4. examine/document progress
5. Modify treatment/intervention if not going well.
6. Patient motivation
7. Research (evidence based practice)
8. Fabrication of orthosis. (orthotic)

Question 4

What is the Range of Motion system?

Answer 4

Measure a general range of 0 to 180 degrees.

Extension of the joint.

Question 5

Define Active and Passive ROM.

Answer 5

Active ROM. Screening tool. What the patient’s muscles are willing to do.

Passive ROM. What we should be measuring. PT move the limb for the patient to determine the full capability of the joint.

Question 6

What is End-Feel?

What are the types of end-feel?

Answer 6

A feeling or sensation experienced by the examiner from the joint as a barrier to further motion at the end of passive ROM.

Normal-Soft, firm, and hard.
Abnormal-the above plus empty (never reach end-feel because of pain.)
The end-feel happens at a point in the range you do not expect.

Question 7

Define Capsular Pattern.

Answer 7

Pattern of proportional limitation of a joint involving all or most of the passive motions or planes of movement. There is a normal pattern for all human joints. If this pattern is compromised, then the joint capsule is involved in the injury.

Question 8

Define Non-capsular Pattern.

Answer 8

Pattern of limitation in a joint involving one or two motions and not in a proportionally limited pattern. (Joint capsule is not involved).

Question 9

What are the 4 key principles of Positioning?

Answer 9

1. Use the Recommended position (always exists).
2. Use the same position each time (accuracy)
3. Avoid two joint muscle tightness. (limits joint mvt.)
4. Avoid changing patient position (reflects PT organization and patient comfort)

Question 10

Why Stabilize the joint?

Answer 10

1. Keep the proximal segment fixed.
2. This isolates the joint being tested to truly reflect motion of that joint. (avoids summation of additional joints).
   (Make the stationary arm of the goniometer stationary.)

Question 11

What are the 4 types of goniometers?

Answer 11

1. Universal goniometer–most commen
2. Gravity-dependent.
3. Pendulum.
4. Electrogoniometer.

Question 12

What is the KEY principle of alignment? WHat is being aligned?

Answer 12

Alignment of the arms of the goniometer with boney landmarks is KEY!
Aligment refers to alignment of arms of the goniometer with segments: stationary w/ proximal and moving w/ distal.

Question 13

What 9 things should be considered for recording (documentation)?

Answer 13

Keys
Examiner name, date, and time of measurement.
Make and type of goniometer (if unusual for clinic)
Side, Joint, and Motion.
Degrees of motion.
Type of motion.
Other objective info.
Abnormal end-feel 
Patient position for measurement.

Question 14

What are the first 5 Procedural Goniometry steps?

Answer 14

1. Place subject in recommended position – drape accordingly.
2. Stabilize proximal joint segment.
3. Move distal segment through available ROM; determine end-feel.
4. Estimate ROM
5. Return to start position.

Question 15

What are the second 7 Procedural Goniometry steps?

Answer 15

1. Palpate landmarks.
2. Align goniometer.
3. Read and record start position.
4. Stabilize proximal segment.
5. Move distal segment through ROM
6. Replace and realign goniometer with landmarks.
7. Read and record ROM.

Question 16

What 4 factors affect ROM?

Answer 16

Age (decreases ROM)
Gender (Women are more flexible)
AROM (Active)
PROM (Passive) 
(Passive is always greater than active.)

Question 17

Define validity.

Answer 17

The degree to which an instrument measure what it is purported to measure.
How well the measurement represents the true value of the variable of interest.

Question 18

Define Reliability

Answer 18

Repeatability.
Referes to the amount of consistency between successive measurements.
Intra-tester v Inter-tester. (Intra is much more reliable than inter.)

Question 19

What is Manual Muscle Testing (MMT)?

What is its purpose?

Answer 19

A system or approach to grade strength. 5/5 max.

To get a grade of muscle strength.

Question 20

What are the 2 principles of MMT?

Answer 20

Use the available ROM

Break Test–Apply pressure to break resistance of held position.

Question 21

What are the 5 steps of application for MMT?

Answer 21

1. Use the mid to end ROM.
2. Hand placement is distal to joint.
3. Direction of force (apply pressure where you really should apply pressure)
4. Gradual (add resistance gradually)
5. Long lever arm (distal to joint)

Question 22

What is the MMT Grading system?

Answer 22

Numerical or qualitative score given to specific muscle or joint motion.

Question 23

What are the MMT muscle grades?

Answer 23

5/5 is normal…The muscle holds against max resistance.
4 is good…Moderate resistance.
3+ Patient hold minimum resistance.
3 is fair…resisted gravity only. (3 and below are objective) Never holds against added resistance.
2 is poor…Full range of motion in a gravity reduced position.
2- Body part goes through partial ROM
1 is trace…Can see or palpate muscle contraction w/ no movement.
0 is zero…nothing happens.

Question 24

What are the 6 basic procedures of MMT?

Answer 24

1. Patient position
2. Stabilization.
3. Move extremity through ROM–Move to antigravity position if needed.
4. Apply resistance
5. Grade
6. Record.